From November CampTalk - Outdoor Parenting

My son went dove hunting for years before he was big enough to shoot. With the safety course under his belt at 12, he became a full fledged member of the opening day group that I had been out with for years. The 4:30 am breakfast, the drive to Snyder, steak the night before at Bucks- all of it took on a new flavor when he graduated from spectator. And, gratefully, in his first year there were a lot of birds and he limited out well before noon. The second morning at the café held just as much promise and excitement and everyone was talking about their failures and successes the day before. Mid breakfast one of the comments caught my ear. If I heard right, some of the guys at the next table had limited opening morning and had returned to a tank that afternoon for additional shooting. I watched closely to see if my son picked it up. It seemed to be going over his head but by now I was hearing more comments about the double dip. This table of guys slowly realized that their discussion was being overheard and that my son was examining them. A friend sitting to my right leaned into my ear and asked me how much Nintendo a reward would buy if my son turned in the poachers. The talk turned and I dismissed the event and never really thought of it again.

I don’t hold myself up as the beacon of ethics in the outdoor world, but I do try to consider what is right and wrong, and certainly what is legal. I learned my lesson when the game warden caught me without a plug over a pond in North Dakota. I explained truthfully to him that I had been turkey hunting the week before in Missouri where plugs were not required. With his ball point pen inserted as a plug and a warning, he sent me back to the pond. I don’t think of myself as particularly virtuous but when I had kids I noticed my behavior was being watched by people very important to me, and ones I seemed to have an impact on. I had no idea I was talking to other drivers until my (then) three year old son asked me “what a gashole was.” I blanched, and told him the best that I could come up with, that it was where you put the gas into the truck. My lesson about talking to other drivers was learned there as well

Last year in Snyder, 8 years later, my son thanked me for not taking him back out to shoot more than his limit on his first opening dove day. “I would have hated to have had to work through that” he said. And I wasn’t even sure he was paying attention.

Side by Side in Camptalk

The following is the article currently running (August 09) in Camptalk, the monthly publication of the Dallas Safari Club. I have secured a column there based on the concept of "Outdoor Parenting." My kids are tolerating it well so far. Time will tell.

Side By Side:
My son got this terrible look on his face. All I had done was ask him to step out onto the porch with me as I needed to talk to him. He didn’t want to go outside and I asked him why. “Because you’re like the Santa Claus of bad news when we have to talk on the porch. It’s where you talk about STD’s, drugs, my speeding ticket, smoking, and every other thing I have ever done wrong.” He really did catch me by surprise. He was relieved to find out I only wanted to ask about his schedule and an elk hunt draw in Colorado. We didn’t draw Colorado that year but he pointed something out to me in the exchange. That is, very little of my “telling” is well received. Truth be told, most of the wisdom I have ever been able to impart to my kids has been while we were side-by-side, certainly not face to face.
“Why does the buck chase the doe?” he asked me when we were sitting on Willow Creek outside Mason. We had let the doe and the trailing buck go but my son tossed me a pitch that any Dad could have hit out of the park. The chance to tell my boy about the birds the bees and the bucks, and he brought it up!
I told him about the rut, I told him about estrus, I told him about fawns and fights and I told him what went where and what happened when it got there. With every piece of information he kind of blinked and adjusted his neck. I finished and let him ponder all of this for just a moment and then laid the punch line on him. “And it is just like that for people too” I told him. With a look of shock and awe he turned to me wide-eyed and said “NOOOO” loud enough that the buck (long since gone) probably heard him.
When you’re side-by-side with your kid you can sneak up on them. For some reason, a kid can talk to the parent easier if both are facing forward. One of the most important aspects of hunting and fishing with my kids has been the windshield time we got to spend together. With a trip longer than the one to the 7-11 the topics invariably get deeper. If you listen you can begin to hear what they truly are worried about and dealing with.
Parenting is more art than science. The sooner we learn to take up the teaching moments when they occur, side by side, the sooner we get to engage our kids about what is important.

Boundaries and Adolescents

My first article published in the Morning News. A client couple had brought me a child to "fix." I needed to work more with the parents than the child.......

Boundaries and Adolescents

This fall I entrust another child to PISD as she moves to middle school. As a parent, I would prefer to continue with Indian Princess. As a counselor I recognize that adolescence has begun, and my task as parent is to provide safe boundaries in which she can grow. Not always an easy task. I remember her and see her as a smaller child but am constantly challenged to see her as a young adult. Boundaries, I know, are to be tested. It is difficult for me to hold the line at times, and will admit that it is easier to do ahead of time, rather than in the thick of the battle. Having done this once already, I see some of the pitfalls that lie ahead. First when you are told by your adolescent (it doesn’t matter if they are 13 or 17….) that no one else has a curfew, it is not true. When you are told that no one else’s parents call to check if there is a parent at the party, it is not true. When you are told that no one else has to call if their plans change, it is not true. When you are told that there is always beer and pot at the party, it is not true. When you are told that no one else has to work, it is not true. When you are told that no one else has to pay for their auto insurance and gas, it is not true. When you are told that everyone is having sex, it is not true. When you are told that no one else has to spend time with their family, it is not true.
If these are true for your child’s friends, then your child needs new friends, because the parents of these friends do not know how to set boundaries for their children, and they are hurting them far more than helping them.
The rough guidelines that we begin with include curfew with acknowledgement that nothing begins until school work is addressed. Once plans are made, we expect them to remain constant unless we are asked about it ahead of time. (Phone calls to ask to change plans at 11:40 pm with a midnight curfew don’t get approved). We expect to know where our kids are and who they are with. At younger ages, I demand to know who is providing the supervision. Even at older ages it is not safe to turn our kids loose to just drive around town with their friends, and come and go wherever and whenever they please.
Growth from adolescence to young adulthood is a big jump. The risk is to allow a child the freedoms of adulthood without the responsibility. I see many parents try to avoid the conflict of having to set appropriate boundaries (and natural consequences when violated), but the cost in abandoning your child is their emotional and social retardation. Once on their own, the child has little else to do but fail. The workforce, college, and the real world in general does not take on the task to provide a responsibility-free lifestyle. Boundaries at their best, keep everybody safe. When responsibility is shown, it is appropriate to move the boundary. It is a fluid process, and one with which I am not always comfortable. I do believe that the struggle is worth it however, our children are too important to simply hand over to the world without equipping them.
P.S. – If your adolescent is female, you need to read Reviving Ophelia, by Mary Pipher.

Marriage Counseling

Better Marriage Relationships

If the truth be known, I am probably only a marginally effective marriage counselor. The only redemption in accepting this statement is that I am not sure any of my peers rank higher. It is not that I don’t have enough education or technique. I have licenses and diplomas that clearly illustrate that I am educated well beyond my own intelligence. There is a contributing factor to this process, however, that limits a counselor from moving the couple along to a higher functional level. That limiting factor is the willingness or ability of the couple themselves to participate.
Whenever a couple comes in, one or both acknowledges that they have problems in the relationship that need to be fixed, and even “probably have some things they should look at about themselves.” This is code for “I need to look like I am open to the process, but frankly, if the other one in this relationship would deal with their issues [that are offensive to me], we would be fine.” The only exception to this slam dunk truth is when one or both have been working on their “stuff” individually before relational counseling and have dealt with their contribution to the relationship. Then the slam dunk truth is only partially true.
As marriage counselors, we work with what shows up in the office and the art of our job is to identify the level at which the couple is playing and try to coach them further up the curve. Again the growth is limited not only by our educational skill but by our ability to relate at whatever level the couple arrives with. So couples, here are some things you can do to further growth in your relationship, whether you use a counseling process or not. As the line goes (with apologies to Jerry Maquire), “Help us help you!”
First, tap into your ability to be self honest. Growth begins when you look at you. Of course you see the faults in the other better than they do. The ability to focus on others rather than ourselves leads to blame which ensures we never see our part. The relationship does not improve until both parts improve their offering.
Second, learn that you are responsible for your own feelings, and your own happiness. If you are not sure of what it is you need or want, how in the world do you expect your partner to participate? Handing them responsibility for your happiness again puts you into the victim role and you hand away the power you have for getting your needs met. “They should know what I want/like without me having to ask for it” is a recipe for disaster, frustration and is not true.
Third, develop better boundaries. Protective boundaries keep us from having to take on what others say or do. Containment boundaries keep us from stepping on other people’s toes. Learn to develop both or you will drain your level of emotional energy that is required to work in an effective relationship. This is very difficult work and most don’t do it very well. I usually spend several sessions with couples just on boundaries. Take a class, read a book, practice with each other. You and the relationship deserve better than what most of bring in the area of boundaries.
Finally, marriage is not a net-sum relationship. There should be unlimited love, acceptance and positive regard. For one to win, the other does not have to lose (a feature of dysfunctional homes). The quick indicator I watch for is the level of reactivity around criticism and defensiveness. Couples describe horrible fights from last Tuesday, but 3 weeks from now cannot even tell you what they were about. This indicates reactivity not a meaningful conflict or difference. Reactivity is always tied to history and almost always predates the couple. Deal with the history and learn about you or you will blame the other for your unhappiness for the rest of the relationship. (Then whoever dies first wins).
Most of us spent more time in Driver’s Ed than we did learning about healthy relationships. If you want to improve yours, growth is available, and it is a rewarding effort. Help us help you.

Relationships on Hold

My son answered the phone one time too many at the dinner table. I'll fix him......... (published in the Dallas News).

Relational Respect

In 1982 I took my first position out of college with Eli Lilly & Co. Probably the greatest perk for that job was the mobile phone (not cellular) they provided us. The handset was mounted on the dash and about the size of a loaf of bread. The box that fueled it was mounted in the trunk and was the size of a small microwave. To get one in Dallas, the wait was 5-7 years, so I drove to Brownwood to get one sooner. The installation only took 9 hours. As you traveled from town to town, you toggled the tower numbers on the control panel according to a national directory you were given. I was always careful to call ahead to let my date know I’d be a few minutes late. It always impressed and to have a mobile phone when no one else did truly fed my ego.
Flash forward 25 years and my 13 year old sends photos and texts on a phone smaller than a pack of cards. We can’t get through a meal without somebody’s phone going off. We sure are in touch with each other. Today, the status is found with the one that can turn the phone off, or go somewhere without it. Kids today (I now officially sound like my father) see nothing wrong with interrupting an in-person conversation with someone to take a call, or respond to a text. Back when Alexander introduced the ringing of the phone to the world, it tapped into a primal need we have to be wanted and valued by another. The urgency in a ringing phone took hold there and has been passed down from generation to generation. An interesting byproduct of this however is that we now claim the urgency of the ring (or vibration) over the actual importance of the call. If you don’t believe me, listen to your neighbor at Starbucks or dinner and pay attention to the inane level of conversation. When did that become urgent or important?
I first thought the cell phone (and email and AIM and etc.) were going to help us improve our relationships. We were going to be able to connect better. We were going to be able to show others we value them. What I see however is how we show the ones we are with how much we do not value them when we place our interest in the unknown at the other end of the cell.
I have begun to believe that this busy-ness (at the expense of the relationship) is so we do not have to deal with others or ourselves at an intimate level. We are, after all, too busy. I have clients, in my office for marriage counseling, who have convinced their spouse that they do not know how to turn off their Blackberry. Please. I have seen them answer the call in my office because it was ringing. At some point intention- and what we want to believe about someone else- gets trumped by what their behavior indicates. When you are sitting in marriage counseling, and you answer the phone, it is because the call is more important than the spouse. Bet if you drop the PDA in a bucket of water it will turn off (or at least mute the ring).
The way to meet the need to be known by another (and to know them) is through appropriate intimacies (that may in fact be through the use of a cell phone) that focus on how we show the other they are important to us. “Put the phone away at dinner” I tell my kids, “and pay attention to those of us, with you, at the table.” There is a time to “check in” with others but not at the expense of the one you are with in person. Especially when on the counselor’s couch talking about marriage problems around communication.

The Usefulness of Al-Anon

A few years back Al-Anon sent out a request for publications, to clinicians who incorporated 12 step programs into their work with clients. That would be me! A peice of this was used in their literature and also led to later filming for an Al-Anon PSA.

One Professional’s Use of Al-Anon

My counseling practice is hosted by a faith-based organization and many clients come in who are trying to manage or begin to understand the disease of alcoholism. The concept of a family disease is usually foreign to them by name, but when we begin to consider behaviors within the family system, the client can usually begin to recognize the pervasiveness of this disease. Given where the practice stands, we usually end up discussing the morality of alcoholism amidst the struggle of family members who are trying to “make the alcoholic quit” or at least modify the other person’s behavior. I explore this desire by encouraging the family members to consider that the alcoholic is a sick person trying to get well, rather than a bad person trying to get good.
Al-Anon is a useful resource for the family members (and friends) to go and explore how they participate in this system, or family disease. We are hopeful about getting the alcoholic to modify their behavior, but I challenge these family members to consider that they need to begin to look at where they can change their own behavior and perspective. I am careful at this point to explain that this is not about blame, but rather seeing the system from third person, and understanding that they need to be willing to work on their own behaviors. We accept that alcoholism is a family disease, and members of the family must show willingness to address this disease if they plan to ask the alcoholic to address the disease. My rule for members of an alcoholic system is that you don’t put more effort into the alcoholic’s recovery than the alcoholic will. But, conversely, everyone must be willing to begin to work on his or her own stuff. Al-Anon is the first place I send clients to help them begin to understand this principle of participation in the system. In counseling jargon, they are invited to understand their own level of self-differentiation within the family. In addition, the principles of Al-Anon promote higher levels of this self-differentiation. A simple example of this is when a member learns and internalizes that they do not have the power to “cause” someone else’s alcoholism. To learn that they cannot “control” or “cure” the disease allows the individual to begin to consider where their level of control is, and how they might engage the alcoholic differently- perhaps even to “detach with love.” (When this is internalized, the family member usually fully grasps the usefulness and challenges found within the Serenity Prayer).
Alcoholism is a family disease, and as such, must be treated within the entire family. The drinking is but a symptom of the problem. Otherwise, abstinence from alcohol would eliminate all problems. Usually not the case. Attendance at Al-Anon is the fastest way I can get clients to engage in a healthy fashion with this disease. I point out that to resist treating their role in the system is no different than the alcoholic refusing to quit drinking. I am convinced that the number one feature of this disease is denial. This is true for both the alcoholic and the al-anon. Solution focus within the meetings and for the participants moves the clients to a place where they gain some relief, begin to grow, and move them to deal with their own situation productively.

Christian Counseling?

Is There Room For Religion in Christian Counseling?

“Do you do Christian counseling?” The caller had asked a question that I have come to fear and one which raises the hair on the back of my neck. I have learned not to answer directly, but rather to respond, “why do you ask?” Sometimes the caller wishes to explore my belief system and approach to counseling, but I am finding that a large percentage of the calls are out of fear and in response to how they have been treated by their last “Christian Counselor.”
In the movie “Leap of Faith” Steve Martin plays Jonas Nightengale- a convincing faith healer/con man who never wavers in telling people to ante-up with their faith and their money if they expect changes in their life. When the changes don’t happen he is happy to allow that his parishioner victims simply did not have enough faith.
When a “Christian Counselor” blames a client’s circumstance solely on lack of faith or a client’s unchanged circumstance on poor prayer habits, it is religious abuse. The counseling process must be about more than religious directives in spite of a particular client’s circumstance.
A 1992 Gallup Poll shows that of those seeking counseling:
“Sixty six percent prefer a professional counselor who represented their spiritual values and belief, and 81% preferred to have their own values and beliefs integrated into the counseling process.”
In light of this, it is clear that most clients seek counseling that will be congruent with his or her own values. But what exactly are the counselor’s values? The range is very wide, even on such basic notions as biblical inerrancy and salvation. There is something very warm about knowing that one’s decision is truly God’s decision. Unfortunately, the counseling does not come with the guarantee that God’s will is truly being followed or suggested. Credentials and licenses may help, but the possibility of abuse is tremendous. Denominational requirements for ordination vary all the way from $25.00 ministerial licenses available on the Internet to traditional Protestant ordination paths of 4-6 years of supervised process and education. Rabbinical pursuits may be longer yet with demands of study in Jerusalem. Licenses are only minimum standards set by secular state government for counseling, and other private associations set their own standards. Some of these designations are truly helpful. Which ones?
Even good intention and piety do not necessarily overlap with quality counseling. If the counselor imposes their values behind the skirts of Divine Directive, again, it is religious abuse. Which teller window is the client stepping up to?
The difference between Pastoral/Christian counseling and secular counseling is directly related to the importance that the counselor and client place on the religious or spiritual influence within the encounter. At one end of the continuum is the position that religion or spirituality plays no role in the process. At the other end is the position claimed by the counselor (and granted by the client) that the counselor speaks for God, and so directs the client. A healthy place for the client to begin this journey of placing themselves on this spectrum is around the their own understanding (I ask them to articulate it) as to why “Christian” or “Religious” counseling is important to them. In exchange the counselor should be able to articulate an answer as to why they claim to be a pastoral or “Christian” counselor and describe and explain their credentials around counseling and ministry. Don’t accept these answers at face value without exploring what they mean for you or for the counselor. If scripture or religion is to be used as a weapon to manipulate behavior or feelings then the client needs to be very cautious, and please, don’t call it Christian or pastoral.

Collaborative Divorce

This was written after I watched (again) a couple destroy their kids in the course of a bloody divorce. Anger usually creates casualties beyond the direct combatants.

Collaborative Divorce and Kids

Time after time I have watched teenagers, just prior to leaving home, initiate conflict or exaggerate a fight with their parents to facilitate the separation. This often leaves the parents confused and hurt at a time they are genuinely trying to connect. The tension serves to equip the child with a framework of motivation to ease the separation. Fortunately, this dynamic plays a useful and timely role in greasing this process, and dealt with productively, plays itself out in a short time frame. I am seeing that this paradigm occurs between adults at the time of divorce, and the dynamic fuels the friction with many couples. Unfortunately, it puts the kids in the family in an untenable position with the potential for elevated pain and suffering.
In divorce counseling, Rule Number One says that no matter how big a jerk your soon-to-be ex is, do not say anything negative about them to the kids. Every ounce of negativity you offer to them in this way will return later on your head with an expanded consequence. I see my clients, children of a divorce, time and time again sitting in my office working out a clearer perspective of truth about both parents. When one or both parents have been negative towards the other, the child always ends up resenting the offender. This is true if the client is 12 or 32, and it is even more heightened if one parent has been lying about the other. The truth does come out. Your not-so-significant other may now be the jerk of your life, but they are still your child’s parent. You do not have the right to manipulate that relationship. All parents deserve a primary relationship with their child, one that is not controlled by another person.
You owe it to your kids to set aside your need to inflict pain. The pain you direct towards your ex will usually take out the onlookers, including your kids. This infliction may provide you with a momentary satisfaction but it will return to haunt you when the children figure out for themselves that you did it. I guarantee it. The fact that you are divorcing is adequate expression that you are both redefining your relationship with the other. You do not have the right to make your children an additional battlefield or you will count them among the casualties. By the way, this principle remains true despite how the other is treating you. I recognize the difficulty in accepting this piece of it, but it is true nonetheless.
Check out the collaborative law process in your state. It is a refreshing approach to this redefinition of relationship we call divorce. In this process, mutually beneficial resolutions are sought and the kid’s needs take on a higher priority in the process. I have seen the process serve the children and the couple well. The process does not work for all, but it is one of the resources available to divorcing couples that can strengthen their concern for the children’s well being.
I can always find common ground with feuding parties, sometimes we just have to take a step or two back from the conflict to see it in a different light. If you begin this separation process with common ground around protecting the kids and putting their needs first you will do a better job, a healthier job, in redefining your relationship. That is after all- divorce at its simplest- a redefining of boundaries in a relationship. You will enhance your relationship with your child if you deal appropriately with them in their relationship with their other parent.

Depression, Suicide, Medicine.

This was the most painful peice I ever wrote. It is the adaptation of the sermon I preached after my friend killed himself. It was a real risk to preach this at the funeral, as I was unsure how it would be received. It was recieved well. After it ran in the Dallas Morning News, it was picked up and ran regionally in various papers.

Depression-Suicide-Medicine
My heart is hurting.
Last summer a good friend of mine died from his depression. As a minister, it was a privilege to serve his widow by presiding at his memorial service. As his friend I have cried before, during and after his funeral. Suicide invites us to evaluate our relationship with the person, and a lot of “what ifs?” and “if only I had…” surface in our mind. Yet as a counselor I know that depression takes people to places they would not go on their own, and at some point, get so far out there they cannot get back on their own, or even ask for help.
It is beyond the scope of this article to go into depression, medicine or suicide at any length but it there is a stigma that surrounds these issues that need to be considered. Mental illness is an organic chemical imbalance. This chemical imbalance can often be addressed in a number of ways. Exercise is one way. We’ve all heard of endorphins and their effect on the brain. While I personally don’t believe in endorphins while I am on the last quarter mile while running on the treadmill (then I only believe in panting), I do know that somehow I feel better if I work out regularly both physically and mentally. There is a physical reaction, an organic reaction that occurs in the brain that addresses the chemical imbalance when someone is depressed. Another way this chemical imbalance can be addressed is through counseling. Changes in brain chemistry can be made with changes in behavior. You can act your way into right thinking (and feeling) in many circumstances. The process is gradual, though remarkable progress can be made. Another way to address the chemical imbalance is through medicine. Sometimes it is the only way, depending on the imbalance.
Depression is best addressed however with a combination of these resources, including medicine. Unfortunately, there is a stigma attached to depression, and its treatment. In fact, this stigma continues with most mental illness. With education and time, I hope this stigma disappears. (We used to believe there was something wrong with left-handed people. Ever heard of a “left handed compliment?” The stigma around being left-handed is the etiological source of this phrase). Anyway, there is resistance to the belief that medicine is appropriate for use in depression. That somehow the individual should just “snap themselves out of it.”
If you subscribe to this approach I would challenge you to tell a diabetic to “just get over it” without their insulin, or that someone should just “snap out” of their high blood pressure. The principle is the same. Medicine can help address the chemical imbalance of the diabetic, one with high blood pressure and the depressed.
I cannot begin to imagine the dark place that my friend found himself when suicide seemed like a good choice. To be in a place where the ending of one’s life looks like a reasonable alternative. To be in that place, something is chemically broken in the brain and the illness succeeded in taking his life. If my practice is any indicator, men seek treatment far less that women do, yet studies show that depression affects both sexes about the same. If you or someone you know suffers from depression (or think you might), please take a step towards health and recovery. You do not have to live like this.
My heart is hurting.

Divorce in the Holidays

Divorce in the Holidays

Relationships can be tough this time of year. I call it the Bermuda Triangle of holidays. For many, this will be the first set of holidays without a loved one. Broken relationships can take many forms. Most in Collin County have experienced divorce in their family. Thanksgiving, Christmas, Hanukah and New Year’s Day take on radically different meanings when it is the first time through without a spouse. In my practice I often hear the same words of loss, anger and depression as those used when we experience a loss through death as well.
I used to think grief occurred like stair steps. You moved through one stage and “stepped up” to the next one. My experience is different than this however. What I have observed with mine and other’s grief is that it is more circular (think Slinky). One day we have a level of acceptance about the loss, and the next we try to deny it. Over time however, we seem to move through all of the stages while returning to each periodically. With time, the rawness begins to dissipate. Sometimes slowly and I am not sure that it ever completely goes away. Sometimes we are given the opportunity to deal with these feelings, these “stages,” at different levels. Like the layers of the onion, we can usually go deeper.
When I facilitate divorce recovery groups (or other loss-related groups) we try to deal with the feelings in a productive manner. My experience is that the groups generally go either into the solution -or- into the problem (sometimes in spite of where I try to take them). My theory is that we must deal with the feelings in a productive way or they are going to come out sideways down the road. A constant look backwards rarely allows us to move into today, let alone tomorrow. It is clear to me that grief involves the sadness of dealing with lost hope for the present and the future. This can be true hope-lessness. With productive, solution oriented work (and time) the hope for the future and the hope for the present can be more hope-ful, but it must be a new and different hope. Grief is about reconciling these two perspectives between lost and new hopes.
Traditions often tie us to these hopes of the past. This is why it is so difficult to experience great times of tradition like Thanksgiving or Christmas. The holiday is just not the same if we all aren’t there. But a new hope-fulness would encourage us to develop a new tradition that helps us move on while still enjoying an existing tradition in a new way.
At the counseling center where I practice we used to use the Divorce Recovery Groups to allow people to vent and focus on their feelings of hope-lessness. We have changed on this. Now, we offer to walk forward with people. Perhaps we are just offering to walk a different part of the journey with people, but my observation is- people continue to grow and move forward with forward looking behavior. We even changed the title, and now call the group “Ready to Heal.”
It sounds simplistic but I have observed that the people who are happy in life are the ones who focus on what they have and the unhappy folks are the ones who constantly focus on what they don’t have. To that end a productive move through grief and loss may include some of the latter but a solution-oriented approach will continue to encourage us towards a focus on what we do (and will) have.

Drive Day For Teens

This is an article that was written as my youngest began to drive. It hit me clearly that she needed as much experience as she could obtain. Not that she is a bad driver (only 1 speeding ticket to date!) but experience does not substitute for ability.

Drive Day

For several years I have modified my email electronic signature to note events or trends in my children’s lives. It occurred to me the other day that a change is impending as my 14 year old daughter anticipates learning to drive.
In Texas the kids get to start learning to drive at 15 or so to prepare for the licensing process. Generally, with a few hours of classroom teaching, the student can obtain an instruction permit once they are 15. This permit allows them to begin behind the wheel education. With a minimum of 6 months of further education (classroom, behind the wheel and testing) the student is eligible for licensing at 16. Even then there are additional limitations on the license. Two that I am very much in favor of are the prohibition of more than one passenger in the car that is under the age of 21. Focus is required for driving and a car full of your buddies does not contribute to this focus. Likewise, they are not allowed to use a “wireless communication device.” Please, no texting or calling while you are driving in the car beside me.
Perhaps because I do have two teenagers, I end up counseling a lot of adolescents and their families. If I can establish a little trust with both sides that come to see me, my greatest ability in the relationship is one of translator. I usually am not invested in what the parent’s issues are and so can work with the kid to get the parents to see life from a teen’s point of view. If I can get the kid to lighten up on the attitude and use adult-friendly language, they usually walk out of the office feeling heard and gain back at least a little of the power they seek. Likewise, since I have kids, and worked in the Trauma Room at Methodist Hospital, I understand parental concern and even fear. I have seen what rolls into the hospital at midnight and I am the guy that had to make that call in the middle of the night. I know first hand what happens in the real world. BTW- midnight is the bewitching hour and kids need to be in before then. I will also admit that what I have seen has influenced where I draw boundaries with my kids (my son once told me that the gift he was going to give to his kids was that he would NOT work in an ER). Since I am not their parent, I can usually say the same thing that their parent has been saying (visualize Charlie Brown’s teacher and “BLAH BLAH BLAH”) for some time but the client-teen will hear it when I say it.
One of the issues that is a regular topic of discussion is when should the young teen start this education process around driving. The idea of Mommy’s little man or Daddy’s little girl behind the wheel is a sobering visualization. Not only does one realize how time has slipped past but also we are immediately struck with the immaturity level of our child and the starting place of “they’re not ready to drive.” It is a constant topic for discussion (or negotiation) in my office. To every parent’s surprise I come down on the side of the kid and encourage the parent to get them started behind the wheel as soon as possible.
Here is my rationale. Call the day that the child gets to drive by themselves (with your permission) Drive-Day. You do have control over when D-Day occurs. Hold out until the child is ready and as responsible as you can influence them to be. But the fact remains that the number of days between today and D-Day are finite. Let’s call that number X Days. Lets call the number of hours that the child practices in X days- call them Y hours. You can control the number of Y hours that the driver drives in X days. Here, more is better. As unnerving as it is, get them out and get them driving. There are things that happen on the road we cannot predict, and no amount of “telling about them” will substitute for experience. Clearly, the way we drive will influence our teens but until they witness another driver blow a red light and nearly kill them while behind the wheel, will they pay closer attention and increase awareness at lights. Putting off their driving will only limit their experience, and ultimately we as parents get to choose D-Day. I want your child (and you want mine) to have as much experience between now and then as possible.

“In the spirit of full disclosure, both of my teenagers are now driving.”
Daniel Gowan

Sex Ed 101

Katie Couric's show ran a provocative, borderline shock value peice about the current language kids use and the codes around parents.

Sex Ed 101

I guess we should all feel better now that NBC’s Katie Couric has given us the code words that teens are using around sex. We can all sleep better with the knowledge that “hooking up” has multiple meanings and that “friends with benefits” does not include health care. It makes for titillating T.V. but how does this information, or the statistic that 4 of 10 fifteen-sixteen year olds have had sex, help us in our community. This subject is not going to go away, and I am sure that it will be controversial to our children’s grandchildren as it is to us. It amazes me however how our society wants to argue and delegate around sex education. Should it be in the school? Should the school teach abstinence? What about safe sex? Should STD’s be talked about? Where have our kids gone to find out about sex?
I would suggest that we have confused the issue. From an educational point of view, of course we need to teach biology. The reproductive system in the human species is not about values, it is a matter of fact. And our kids need to know these facts.
It is the issue of the timing about reproduction, methods of birth control and issues of sexually transmitted diseases that cause the discussion to heat up. As a counselor and as a minister I offer that these issues of value and morality do not belong to the government, but rather, to the family, and by extension, the church. Sexuality is a gift from God, one meant to be enjoyed, expressed and appreciated. This is not a new role for the church, i.e., discussions of morality, simply one that the church needs to reclaim.
Where have you stepped up to enhance the biology lesson with discussions of morality and values with your children? How do you model respect for the other sex in your relationship with your spouse? When have you discussed the differences between men and women and their approach to visual images? How has this discussion informed the way your daughter dresses in public? I am not a prude, but I was dumbfounded last week to see a well developed female teenager 14-15 years old wearing a revealing t-shirt (she had ripped it to show cleavage) with the inscription on the front that said “Porn Star.” She was shopping with her mother. How have you talked with your son about pornography and the relationship between these images and real life relationships?
Personally, I do not want PISD teaching morality to my children. That is not their job (and by the way, they don’t want it), but becomes their responsibility when we saddle them with teaching anything other than biology. I do however, expect my church to step up to the plate here. Sex education needs to be a process, not a one-time discussion. As kids age, we need to continue to address it as their experience and understanding increases. The pastoral counselor in me tells me that our churches need to be the voice in the wilderness on this issue. We need to provide this structure, influence, support and safety to our kids.
If you think a “just say no” campaign is working, you have your head in the sand.

Cyberspace with Kids

Technology is moving way faster than I am. And my kids (and yours) are right up there with the cutting edge of it. We need to pedal faster if we want to keep them in sight.


Walking With Our Kids Through Cyberspace

In the course of my counseling teens and their families one of the subjects we invariably get around to is computer usage. Unless Mom or Dad is in the computer business or high tech, the kids are savvier than the parents are. The somewhat offensive notion that we used to hold about our parents being a little doddering and out of touch has come true. Unfortunately we are them. Most, if not all, of my adolescent clients have their own web site under My Space or Facebook. Does your child have one? This is a site where anyone can claim a spot and start posting information, photos, music, video and invite comments from others. In an attempt to stay connected with my clients I posted my own MySpace (Actually my 13 year old did. This is obvious when you see that my profile tells the world that the focus of my world is my daughter and “I devote my life to serving her because the world revolves around her!”). I am then invited by others into their world on MySpace. In my “network” I am connected to 171,950,541 others. Friends of friends. There exist minimal safeguards to the sites for the underage. They must invite you to join their sites. I have the privilege of seeing what is on your child’s site. You clearly do not know what is out there, or at least we need to visit about what you are allowing your child to post. Risqué pictures, blatant racism, simulated sex video and provocative blogging. As you might imagine, meanness comes out as well. The drama of High School is now played out online as well as in the halls of the school.
Whenever I notice societal trends that concern me, I always pause to remember the video of the preacher of the 60’s ranting and berating rock and roll from the pulpit because it was going to destroy society. “Ask any young person what they like about this rock music- they will tell you it’s the beat!” 40 years later I am still trying to understand what is wrong with rhythm. So I try to be cautious before raising an alarm. I suppose what concerns me most is that without guidance, our kids are exploring uncharted waters. We are somewhat cautious about what our children are exposed to. That is what rating systems are about at the movies. We get the opportunity to help shape what meaning our children make of various information pieces. And, we get to help them relate consequences to behavior. If we do not walk with them on the computer, we cannot offer this to them. We used to think that the brain was pretty much developed by the mid teens. Newer research shows that the growth and maturation of the brain does not occur until about 22. What this indicates to me is that we cannot blindly allow our children to wander with no boundaries. Most parents would not turn a young teenager lose in downtown Dallas but that is exactly what we do with their brain as they go into a computer we don’t know how to navigate. It is seductive for them to use that space to practice relationship skills, and explore their creativity, but boundaries need to be offered, and most parents are not taking advantage of this opportunity to help shape their children.
College students are finding out that posting inappropriate material on the Web comes back to haunt them at job interviews when their activity no longer remains anonymous (it really never was anonymous, it only seemed so). Likewise for a young teen to fantasize or report about something they have done will bring consequence.
This is a great intersection for the parents to discuss trust with their child. The teen is going to rightly seek privacy. But trust must be earned, not simply granted. And its earning occurs with proof that appropriate choices are made. I would offer that the child gets to access their site and post whatever, but we as parents must maintain the right to cruise through it at our discretion. Again, this is a great opportunity to sit with them and reflect on what you see on the site and what it means to your child. I am not naïve enough to believe that this will be a welcomed activity (I too have teenagers), but you owe it to your child to know what they are doing in their neighborhood, and who is in it with them. The big difference today is that it is a neighborhood that we did not have access to when we were their age.

Adolescent Freedoms With Responsibility

This ran originally in the Dallas Morning News, then was picked up and ran with the United Methodist Reporter.

Freedom and Responsibility

As a Dad my fifteen year old tunes me out at home, but as a Counselor my adolescent clients are surprisingly candid and willing to talk about their lifestyle and what is happening in their lives. The parents of my daughter’s friends all know what I do for a living. When we run into each other socially someone usually prods me to find out what is really going on in our teen’s world. I avoid working when away from the office and can usually short circuit the conversation by saying they don’t want to know. If they really push, I threaten to tell them. They end up agreeing with me.
Kids who are having a great year don’t end up in my office so we understand from the start that the population I work with is defined up front by their propensity for some problem. There are some common threads that run through this group, common denominators that we as parents overlook at our peril and at our teen’s expense.
First is unsupervised time. What most parents forget, or never realize, is that identity is formed in tension with other individuals. We try on our identities, we practice our identities, and hopefully we end up choosing to become what we are called to be. But in this “practice time” the practice is usually in an area that parents should be cautious of. Muscles are formed when we exercise them. Bones decalcify in space without resistance. And our identities do not develop unless we are acting against something or someone else. The parent’s job here is to put some parameters on where or who this someone else is. I believe we are allowed to jerk our children back off the edge of a cliff and sometimes we need to. But if we don’t even know they are walking on the ledge we cannot participate.
Second, we need to attach responsibility to the freedom that the child seeks. Our kids are all about this idea of freedom and our role in this is to show them how to appreciate it. Appreciated freedom manifests itself in responsible behavior. I saw a very thought provoking editorial cartoon once that made this very point. Frame one posited “Two good examples of why we should leave our kids more than just money.” The next frame showed Paris Hilton and Brittney Spears on a drunken spree. When we are given freedom with no responsibility we never learn how to appreciate it or use it wisely. To do this, simply offer your child alternatives without taking their choices personally. Be home by midnight or lose the use of the car tomorrow night. Do your chores or don’t go out. Hand them back the power to choose and then their choices will reflect the opportunity to claim the responsibility that needs to accompany freedom. And the best part for me is that I get to recognize that their choice is then their responsibility and I do not have to invest in which choice they make.
This latter principle is directly related to the final one I offer you. Get with the other decision makers in the house so one of you does not erode the other’s power. Yes this is difficult, particularly in extended and mixed families. But if we can agree that the health and growth of the adolescent trumps all else, then we stand a chance of finding common ground upon which to offer these choices to our child. I had one client who had lost the use of his car as a reprimand. With some coaching, I told him that we could get the use of his car back if he would agree to be home by curfew (and he would have to do it on a consistent basis). He smiled and declined because he knew his Dad was going to give him back the car soon enough and Mom and Dad never agreed on curfew anyway. When Junior was out, he simply waited for Mom to raise the heat enough in messages to him on his cell that he would then call Dad back and assure him that he’d be home “soon.” In the vagueness of “soon”, he could get Mom and Dad to fight over the specific time, and Junior got to stay out drinking.
Responsibility must accompany freedom or it is really indulgence. If we as parents are not going to insist on this responsibility then we are abandoning our children. It might even lead one to suspect that our refusal to insist on this teaching with our children is the source of the lesson the child is learning. Our children deserve better.

Insurance Crisis

I finally figured out the role of the insurance company in the health care crisis. God help us all if the government steps in to "improve" what we have now. (That last sentence is code for "we are screwed")

Insurance Crisis

Last summer, after much encouragement from my wife, I made an appointment to see my physician about my snoring. (I was sleeping just fine- thank you). I am on my wife’s health plan and we hoped that since we were on the top tier plan (that means most expensive), that perhaps any necessary treatment would be a covered benefit. After a physical we found out that I was pretty healthy but I needed to watch my cholesterol, and a sleep study was warranted. The sleep lab called and had approval for the study from my insurance. What you go through for this evaluation is fodder for another story but suffice to say that for me, the emphasis was on their study, not my sleep. At any rate, after the doctor reads the evaluation he tells me that yes, I do indeed need one of those night time breathing machines, but will require another study to determine appropriate settings. The study was approved by Insurance Almighty and the study completed. My healthcare coverage even included the cost of the C-pap machine. We were told. At this point some of the claims started being rejected. I will save you the 6 hours of discussion that it took for me to finally glean what had happened. It seems that sleep disorders are not a covered benefit for my policy in 2007 (ironically they are in 08). My insurance “Claims Representative” was very helpful in telling me they should not have approved the work. At this point, the lab was paid but they were stiffing the physician. On my initial round of calls Cheryl in Chicago tells me that this was going to be called “an exception.” The mistake was theirs, and all associated work would be covered. Sounded good, but 3 months later, the bills are still unpaid, and the Supervisor I have appealed to tells me I never talked to Cheryl and I have never talked to Chicago.
At this point I find out that my wife’s employer actually has a contract with a negotiation company whose sole purpose in life is to argue with Insurance Almighty. Kind of a nice benefit isn’t it? What it tells me though is that this runaround we all get from the insurance companies is now standard practice and to be expected. The employer provides health insurance but only with a company that is not going to pay (at least not without hours and hours of arguing). This health advocate company also had my claims denied. I was left with one final appeal before lawsuit, and the insurance company finally paid.
In this same time frame I have had lab work to check the cholesterol. The lab has not been paid because the same insurance company has told them that my wife and I have other health insurance so they won’t pay. I am up to the appeal process here.
In gaining pre-approval for a colonoscopy (yes I am that old) the medical office said they were told it is covered benefit three calls our of five, so we went with the assumption that it will be covered. (My doctor said they used to do two calls out of three, but lately have had better accuracy with three out of five).
My father died last year and one of the kindest things he ever did was line up his own burial. One of the features he paid for was a life insurance policy that would pay off the arrangements if he died before payments were finished. We got the bill last week that said since my father died, he must have had a pre-existing condition that led to his death so they are not going to pay off his note. Huh? The doctor says the cancer wasn’t diagnosed until a year after dad bought this contract but maybe the insurance company knows something the oncologist doesn’t. I am not sure dad is all that willing to pay the difference at this point. I certainly am not.
When the recent storms took it’s toll on my satellite dish I dreaded what I knew was going to happen when I called the utility company. I am amazed to say that I now prefer to deal with a utility company over my insurance company. My only offering to you is that when you see the battle coming, start with a fresh sheet of paper and log all that is said. Date, time, who you talk to, content of conversation and ask for the reference number of the call. If I had an easy way to do it, I would record all calls. When I used to get that warning that “this call may be monitored” I had begun to hope that it was. But then I realized they may be monitoring the call to chastise the rep for being too helpful or too honest. A physician client of mine says this is standard operating procedure now. I do not know where this insurance thing is going, but if our own insurance company has become the enemy of our health, what is the point of having insurance at all.

Natural Consequences

This is perhaps the most practical article I have ever written. It followed the article on boundary setting with children as a practical "how to" to guide setting consequences.

Natural Consequences With Children

I have spent 16 years trying to give my experience to my children. I have concluded that this attempt has been a horrible failure as it relates to changing their choice of behavior. As I have watched others struggle with child rearing, and struggled myself, I have concluded that natural consequence is the most effective behavior modification available to parents. There is a theory of learning and behavior modification that states right thinking will lead to right behavior. It is wrong! Thank goodness this thought prevails or the sale of self-help books would plummet! Experience will show however that you act your way into right thinking, you do not think your way into right acting. This is why it is so difficult to tell a child what to do. The consequence of a behavior is a far better teacher than anything we are going to tell them.
Experience in life is about action and consequence. As parents, then, the best we can do is hope that reflection about the consequence will lead to changed behavior. When the consequence is related to the behavior, this child then is faced with greater stakes the next time the situation arises. It would be nice if we could simply confer as parents and come up with a rolodex of behaviors and then list the corresponding natural consequence we would like to impose, but it is rarely that simple. I have found however a few principles that help me determine where to go in correlating consequence with behavior.
First, the parent must not “fix” all of the child’s problems. If you save the individual from the consequences of their behavior, then the behavior will not change. Completing the science project for them because they started too late only fosters a dependence on you, rather than moving them towards independence.
Second, consequence needs to be related. If the issue with the child is not calling to check in while at the mall with friends, they will not relate to a consequence of extra chores during the week. Perhaps loss of the cell phone for a couple of weeks is more important and understandable to the child.
Third, the consequence needs to be reasonable. If the child is responsible for feeding the family pet, we don’t let the dog die of starvation. We can relate the issue of eating to the situation and then Junior does not eat until Fido is fed.
Finally, the consequence must keep the child safe. If the issue is drinking and driving drunk, it is not safe to let them drive drunk and wait for the wreck. The safer consequence for driving impaired is not driving. Love is defined by Peck (The Road Less Traveled) as “the extension of ourselves for the purpose of nurturing another’s spiritual growth.” I like that. When we set appropriate boundaries and consequences for our children, we are expressing our love for them. It is not love to simply let them do what they want. Our job as parents is to equip our children as they grow to meet the world on their own. They will not always have us there to save them, and it is our job to teach them how to be in this world without a dependency on us. Natural consequence will help us do that with them.

The (High School) Senior Rebellion

What my kids are only now starting to figure out is that I get even with them in my writings. I only change the names to protect the guilty. My son was a high school senior when I wrote this.


HS Senior Rebellion

If you listen carefully, you can hear it all over Collin County. It is a disquieting noise, one that parents initially find annoying, but annoyance quickly turns to concern and exasperation. It is the sound of high school seniors hitting the “stupid wall.” The sound has a familiar ring to it, it happened last year at this time. It happened the years before that and will happen again next year. To the untrained ear it sounds a lot like the noise that would be made if you walked head long into a wall you didn’t know was there. Thunk.
My counseling calendar fills up every year at this time. It seems to coincide with the mail order arrival of high school graduation announcements. Normally bright, intelligent creative kids turn into thoughtless, unethical and mostly selfish creatures. When asked “what were you thinking?” you are met only with blank stares. They are only a shadow of their former selves.
I used to label these behaviors as simple rebellion but I have come to believe that this morphing is playing a useful role in facilitating the fast approaching flight from the nest. (I’ve been practicing my kicking motion for some months now). Tied closely to this is the opportunity for conflict to arise either over the behavior, or in some cases out of nowhere. The behaviors and the conflict are a natural part of the growing process and one which all kids engage in to some degree. This conflict facilitates independence and allows the child to focus on their own anger or the parents “unfairness” as a type of emotional rationale to separate and leave. The explanation is very intellectual but very unsatisfying (and usually forgotten) in the face of dealing with absurd, previously unconsidered, behavior.
What’s a parent to do…. Here, I speak as much as a fellow sojourner as I do Counselor. First, we must maintain the appropriate boundaries. Stick with me parents- there is strength in numbers! As the kids hit 17, 18, and 19, they want more freedoms and we should give it to them. But we must hold the line somewhere, and honestly, I see that there is a part of their development that needs to know where the boundary is. It should be a flexible boundary, but one that needs to be pointed out when the idiot behavior manifests itself. When curfew is wantonly disregarded, take away the car, the phone, the cash- take away something- so they don’t just blow by the boundary again tomorrow. If the standards of truth in the home are taking a shellacking, examine the truth with them using your understanding of true and false and encourage their acceptance of your truth. Again, natural consequences should guide your choices on behavior modification.
Perhaps most helpful to us as boundary setters is to get support. We must stay united! In the midst of the crisis I find it useful to run my thought process (and intentions on correction) by someone else who has been there before. I personally use a couple of guys whose kids are a few years older than my own and they seem to appreciate the opportunity to help out. My initial response is almost always nuclear, that is, make the consequence so horrible that the offender will never consider doing it again. I think. This doesn’t work. It builds resentment, creates pushback and will not change behavior in spite of momentary satisfaction on my part. (It is sort of like revenge, it feels good initially but doesn’t ultimately serve a useful or healthy purpose and leads to remorse). By talking with others who are not involved in the battle I can take advantage of their perspective. If we choose our mentors carefully we will gain the benefit of their experience.
The process is moving as it is supposed to. (I keep having to repeat this to myself, and will soon believe it). Be strong parents- we can prevail!

Sex Driven Values

Sex Driven Values

In line at the grocery store I was struck by the cover of the December issue of Cosmo. Eva Longoria was smiling to greet my 13-year-old daughter and I, and her top (Eva’s) was just low enough to accentuate the cleavage. Promised topics in this issue included “Guys’ Sex Drive- The Dirty Little Bedroom Secrets Nobody Wants to Talk About.” And: “Girl On Top- The 9 Pleasure-Maxing Sex Positions Will Send You Both to the Moon.” And: “The Sexiest Things to Do Before Sex- Discover The Real Meaning of Shower Power.” And: “Your Sexual Health- STD News Gynos Don’t Share.” And we are told, Eva’s interview is the “sauciest ever.” It is explicit. The Holiday Issue!
I am not a prude. Sensuality, sexuality and sex are fun. But so is emotional connection. My issue with the issue is the presumption that the standard that Cosmo posits is the one that Society seems to accept. Sex drives differ. Happy, successful couples have a regular, healthy sex life. But the “regular” part is one they have worked out. Not Cosmo or Madison Avenue.
Next time you are in the bookstore wander over to the magazines. Look at the covers found in “Men’s Interest.” Now go over to “Women’s Interest” and compare. Same women, same flat stomachs, same promise of sexuality. When parents of adolescent boys come to me with their concerns over their child viewing internet porn it usually takes a few minutes for the parent to sort through their concerns and fears for their child. But one of the resounding themes that emerge is that real life sex is not like that. Non-stop sex at the drop of a hat without intimacy is not healthy. Nor is it realistic. Cosmo disagrees. We are told all about women’s sex drive in their advise to men. “Chances are, your little bed devil is usually up for a hearty roll in the hay. (She’s a Cosmo girl after all).” Look, I understand that Cosmo is about selling magazines, not setting standards, but enough exposure to this message places unrealistic expectations on a sexual relationship and the individuals in the relationship.
Often, if not usually, couples have differences in their sex drive. On a scale of 1-10, Cosmo would have us all at an 8-10. Reality shows that like most things, most of us are at a 4-6 and there are about the same number of 2’s and 3’s as there are 8’s and 9’s.
I counsel couples to begin discussions on where their relationship needs are in four areas when we look at this topic. (It is useful if you have been married 2 years or 20 years). First, ask and offer what the needs are for you and your partner in the areas of physical intimacy (hand holding, neck rubs, pats on the fanny). Second, consider your needs in the area of emotional intimacy. Honestly, this is usually harder for guys than it is for women, but it is worth the effort, if both can be honest with themselves and with each other. Third, what are your sex needs? Are you a Cosmo bed devil that falls on a 9 or a 10? Or are you with the rest of us with needs closer to the middle. Problems arise when a 3 marries an 8 and they cannot resolve it. The anxiety over this will come out sideways in the relationship. Finally, where are you, as a couple with your lovemaking needs? I’ve got to tell you that it took me a long time to understand that this was not the same as sex. Maybe it is a guy thing, but a healthy discussion between partners may free both of you up to move the relationship forward in this area.
What limits you from enjoying or participating in these areas? Where do your ideas overlap? Where can you work on compromise? Perhaps most importantly, what is “regular” to ya’ll? Your relationship will benefit if you recognize that these areas are best defined by you both, not by Cosmopolitan. A gift to each other.

End of Life Choices

I worked at Methodist Hospital for years in Dallas. Part of my responsibility was to help develop and support a Palliative Care consult service for the hospital. The Terry Shavo case several years back was a common occurance. Thankfully, the method by which the government in Florida chose to participate was not.

End of Life Choices
We should be very very scared of what is going on in Florida right now.
Try to put Terry Schavo out of your mind and walk with me down a path that you will likely walk for yourself or with someone you love. As a patient in a health care setting, you have the right to make choices about your health care. This principle is called autonomy. It is the right that ensures that your choices are honored. It is the responsibility of the medical team to bring you information about your condition and bring you appropriate alternative approaches to deal with your situation. But ultimately the choice of treatment is yours. This is straightforward so long as we deal with a broken bone or a readily treatable infection. But what happens when the stakes are higher. We in the United States do a lousy job at end-of-life care. In part, I believe we suffer from the societal denial that death will ever affect one of us individually. For whatever reason, we sometimes shut our brains off and allow medical decisions at end of life to be driven by technology. You may well find yourself in the situation of having to ask the difficult question of “just because we can, should we?” When at that juncture, who do you want to make medical decisions for you? For myself, I would like to be able to include a team in making this choice. My team would include the medical staff, my family, and perhaps my minister. Ultimately however, it should be your choice.
But what happens if you become incapacitated and unable to speak for yourself. Who do you want to make your choices for you. It has long been recognized that this decision should go to next of kin. Theoretically, this is the individual that would know you best and be in the position of being able to decide for you as you would decide for yourself. We are given the opportunity to specify this decision maker through the legal device of Medical Power of Attorney. It is available at any hospital, or, your lawyer can help develop one for you. In addition, there is a device in Texas known as the Advanced Directive to Family and Physicians. This instrument may be used to help provide information to the decision maker that the physician will be looking at to make the decisions you might be unable to make for yourself.
Back to Terry Schavo. My thoughts and prayers go out to the family. My issue with this situation is not about the choices that anyone is making, but rather that the Terry Schavos right to autonomy has been violated. It should scare you that the individual that is legally chosen to make Terry’s decisions for her, choices that she herself wanted, has been unable to speak on her behalf because the government is trying to choose differently.
I worked for three years as Palliative Care Chaplain at a local hospital. As chaplain, it was my job to walk with families such as this in this difficult time. It was not my job to make decisions for the family, simply to support them as they chose the path that was right for the family, right for the decision maker, but most importantly, right for the patient. The results of these decisions were not the same from case to case, but we were always clear that the decision maker did have say. It was a much easier choice for the decision maker when a discussion with the patient had been held and everyone was clear on the patient’s wishes. They were harder choices were made when families had to guess or even argue about what the patient would have wanted.
The choice to continue, or discontinue life support, be it ventilator support, artificial hydration or artificial nutrition are medical treatment choices. One side of Mrs. Schavos issue wants to claim that she will “starve to death” when in fact, based on her own desires and understanding of the situation, the governmental interference is extending her suffering. If you were the patient, would you want to make these choices for your treatment, or would you prefer to designate a decision maker? Please be clear, now, with your family and loved ones what your choices are to be, and put the necessary forms on file with the health care facility, your attorney and your family.
And pray that the State and Federal Government, and George W. Bush do not take a political interest in your situation.

The Price Parents Pay

My practice (and my family) sit in West Plano, a high prosperity area. We chose to live here 20 years ago based on an outstanding School District rating. It has not been without cost however. This is a response to the News articles on this area.

The Price Parents Pay
With a senior at West, I was not surprised at the stories of excess that were relayed in the Dallas Morning News series The Price of Prosperity. As a parent, I too readily recognize the pressures that my kids face to “keep up” as well as the internal tension I personally have to deal with as I grapple with my own history and the desires I have for my children. As a counselor I have come to see that parental responses to kids over issues like spending and accountability fall along the traditional bell curve. My admission here is that I probably fall onto the more conservative/strict half of the bell than do many parents. With that caveat aside, I would also submit that the point of the series was that the whole curve is skewed with the level of prosperity that is found in parts of Collin County. So the task of modeling and instructing appropriate behavior for our kids does become a challenge.
I asked a parent/client where balance was for them on this issue, and he laughed and said that it was the point they waived at as they shot from one extreme to the other. I can relate. For us, we have found that balance on spending must include participation by the child in setting limits. In addition, the child must have the freedom to choose an alternative within these same boundaries. Credit cards with no limits don’t fly in our house.
We gave my son an old truck of mine when he began to drive. He is expected to pay for gas and insurance. This meant a job, or no truck. What he has discovered recently is that it is a gas guzzling truck. Gas is costing more. More hours of work vs. fewer miles driven. (See how nicely this is starting to work?) He has his own checking and savings account, and is expected to keep up with his debit card. I was surprised however when he relayed that in class the other day, only about half the students had a checking account and that of those, only 2 of the kids balanced their own checkbook. We gave my son a pay as you go cell phone and started him with a few minutes. It is his responsibility to pay for it. His time, his minutes, his money. He gets to see the relationship first hand. I will add that we will occasionally buy him a card for phone minutes and a tank of gas, but we try to hold to the principle that he is ultimately responsible for these items.
We have also begun to encourage savings. Do the math with your child on a Roth IRA that begins at age 16. It becomes easier to get a buy in around the savings plan. (I wish my Dad had done that for me!).
Our daughter gets a (fairly) regular allowance that has some flexibility for more dollars with more chores. When the “I wants” start, we defer quickly to “You’re welcome to use your own money.” A level of thoughtfulness then ensues about how important the want really is. It is this consideration that I believe we are trying to instill.
To ignore teaching these lessons to our kids sets them up for failure unless the money is always going to be unlimited. (Sorry, I can’t speak to that situation…) Consumerism is a big deal these days for them and for us. I believe we owe it to our children to teach them how to match wants and needs with reality and ability to pay. The cost in not doing this is a harsh harsh lesson for the child down the road when there may not be a safety net.

There Is A Solution

There was a feature article in the Morning News about a families tragedy around addiction. This was my response, to encourage others in seeking recovery. I was pleased that the News ran a parallel response from another counselor as well.

There Is A Solution

As the Witherspoons have experienced (“Drugs and a brick wall” Dallas Morning News 12-31-06) mental health and addiction treatment options are difficult to find and are within a system that is difficult to navigate. The pendulum of excess for treatment options peaked in the late 80’s/early 90’s. The swing cannot rebound much more to the other extreme. As a society we desperately need to move back towards a sane balance where people in need truly do have more alternatives to treatment, health and recovery. However even today there is a solution for those suffering from addictions.
The natural progression of addiction continues to drive individuals to new bottoms. But in this downward spiral there is hope. With each new low is the opportunity for the addict or alcoholic to move thru their denial and seek recovery. Twelve Step groups such as Alcoholics Anonymous and Narcotics Anonymous do work and they are widely available. Early AA quoted a recovery rate that is seemingly higher (over 50%) than current recovery rates suggest. There is significance in this and it is actually positive in that in earlier times (AA began in the 30’s) only low bottom cases were able to grasp the steps and principles necessary to move to recovery. It had finally become “bad enough”. If one suffering from addiction finds that it is now “bad enough” recovery can be achieved. They can step off the downward spiral before it crashes at the bottom. The tremendous value in 12-step groups is that they are widely available, the program is affordable and it works. But willingness is the key. They are programs for those that want recovery- not necessarily for those that need recovery. As a clinician I would prefer to prescribe medical detoxification followed by in-patient treatment that would progress to long-term support and recovery. This isn’t always practical or affordable. But recovery is available to the suffering by going to meetings and investing fully with the experts on abstinence. To the suffering I would say, “Go and do what they tell you to do.” They have a vested interest in making recovery available to you in sharing their experience, strength and hope, and recovery is possible. If you are unwilling to choose this path and still insist on doing it “your way” you might pause a moment and reflect on how well “your way” has worked so far.
Addiction to alcohol or drugs is very much related. 12 Step groups have emerged to focus on one issue or another and their traditional approach is designed to maintain an integrity and survival of each group around a specific issue. But the pure addict or the pure alcoholic is rare. Often the addict doesn’t wish to admit that alcohol may be a problem (they are reserving their right to get high with a liquid) and the alcoholic doesn’t wish to include their prescriptions or other drugs in their abstinence. Many (including myself) believe that AA was divinely inspired-and is probably not coincidence that one of the co-founders, Dr. Bob Smith, was addicted to both drugs and alcohol.
Perhaps surprisingly I make more referrals to Al-Anon than I do to other 12 step groups aimed at the alcoholic or the addict (such as AA or NA). The number one feature of this disease is denial and family of the addict or the alcoholic often sees the addiction much clearer than the user. The Al-Anon Family Groups are a fellowship of relatives and friends of alcoholics who share their experience, strength, and hope in order to solve their common problems. Addiction is a family disease. As such all members suffer, not just the alcoholic or addict. Al-Anon provides relief. The family of such an alcoholic usually needs relief as bad as the addict does. As an indicator, if you have read to this point and have decided you need to give this article to a friend or relative who is addicted, you probably will benefit from attending Al-Anon. Until a surrender of “I will do whatever it takes- even to go to THOSE meetings” occurs, the untreated will continue to suffer. (This statement addresses both the addict and the family members!)
Medical detoxification is often necessary. This is available as emergent medical care. Emergency rooms cannot turn people away who need serious medical attention simply because they do not have insurance or cash. (They are also not going to spend much money or energy on a patient beyond the crisis). So the patient must step into recovery immediately following detoxification or the relapse is almost certain. Go to a meeting today.
At the St. Andrew Counseling Center we offer public lectures on the second Tuesday of each month around issues such as these and you are invited. They are free, and child-care is provided with notice. The next lecture is Tuesday, January 9 at 7:00 pm at St. Andrew United Methodist Church in Plano. Dr. Daniel Frigo, Assoc. Professor of Hazelden Graduate School of Addiction Studies in Minnesota will speak on “Work and Recovery: Living the Twelfth Step.”
There is a solution.

Daniel Gowan is a Presbyterian Minister that offers private counseling at St. Andrew United Methodist Church. His practice focuses on family issues, addiction, grief and depression. He can be reached at 214-291-8077 or at www.DanielGowan.com.



Alcoholics Anonymous http://alcoholics-anonymous.org/

Narcotics Anonymous http://www.na.org/

Al-Anon Family Groups http://www.dallasal-anon.org/

St. Andrew Public Lecture Series http://www.standrewumc.org/public.html